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At the beginning of the pandemic, experts expected an increasing number of hospitalizations in forensic settings, uncontrollable outbreaks of COVID-19, and deterioration of mental health of residents within institutions. Certain publications corroborated these concerns;however, no synthesis of the results of empirical publications at the initial stage of the pandemic has yet been conducted. Three rapid reviews were conducted on these topics. Besides almost a two-fold decrease in the total number of urgent consultations/hospitalizations, there were no changes in the number of involuntary hospitalizations, suicide attempts, and psychoses. The COVID-19 morbidity and mortality rates in secure institutions were compatible with the general population. However, the lockdown period was associated with a significant increase in self-harm in secure settings.
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Self-harm and other mental health difficulties are very common amongst university students, but students face numerous barriers in accessing professional support. Support offered via a smartphone app may help to overcome some of the barriers they face, while providing support that is acceptable and helpful. However, there is limited research on supportive apps for students who self-harm. This study aimed to evaluate a self-help app (BlueIce) for helping students manage their self-harm, mental wellbeing and coping ability. This was a pre-post study in which 80 participants completed baseline measures online and were sent a link to download BlueIce. Of these, 27 completed follow-up questionnaires six weeks later assessing anxiety, depression, self-harm, and coping self-efficacy/styles. At follow-up, participants also completed a questionnaire evaluating BlueIce. Self-harm urges and symptoms of anxiety and depression significantly decreased, and coping self-efficacy significantly increased. Around two thirds (64%) said that BlueIce had stopped them from harming themselves an average of 24 times. Feedback showed that BlueIce helped provide a distraction in difficult times and helped them to manage their emotions in a more adaptive way. Following the trial period, participants' wellbeing had significantly improved, suggesting that BlueIce may be helpful for university students in managing their self-harm urges and general mental health.
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OBJECTIVE: The mental health impacts of the COVID-19 pandemic have been widely felt among already vulnerable populations, such as U.S. military veterans, including a heightened risk for depression and suicidal ideation. Support hotlines such as the Veterans Crisis Line (VCL) took a central role in addressing various concerns from callers in distress; research has yet to examine the concerns of veterans who used the VCL during the early months of the pandemic. METHODS: A mixed-methods analysis of characteristics of veteran outreach to the VCL during the first year of the COVID-19 pandemic in the United States was conducted on 342,248 calls during April-December 2020; 3.8% (N=12,869) of calls were coded as related to COVID-19. Quantitative examination was conducted regarding COVID-19-related reasons for contact, suicide risk screens, and caller concerns; 360 unique calls with synopsis notes that included a COVID-19 flag were qualitatively analyzed. RESULTS: Quantitative analysis of the calls with a COVID-19 flag revealed mental health concerns, loneliness, and suicidal thoughts as top reasons veterans contacted the VCL during the pandemic. Qualitative analysis identified specific economic and mental health concerns, including negative impacts on income and housing, increased feelings of depression or anxiety, and pandemic-specific concerns such as testing and vaccine availability. Disrupted access to resources for coping, including support groups or gyms, had negative perceived impacts and sometimes exacerbated preexisting problems such as substance abuse or depression. CONCLUSIONS: These findings emphasize the role of VCL as providing general support to veterans experiencing loneliness and supplying assistance in coping with pandemic-related distress.
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Genetics of multiple sclerosis severity A genome-wide association study in 2000 individuals with relapsing remitting multiple sclerosis failed to identify any genetic variants with a powerful influence on clinical outcomes. A machine learning algorithm using information about 60 000 single nucleotide variants did have some predictive value, but it could explain only a small proportion of the variability in severity of the disease. Brain derived neurotrophic factor, a protein that has been shown to boost neuroplasticity, synapse formation, and cognitive performance in animal studies, may be involved.
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This book contains a compilation of papers presented at the International Psychological Applications Conference and Trends (InPACT) 2022, organized by the World Institute for Advanced Research and Science (W.I.A.R.S.), held in Funchal, Madeira Island, Portugal, from 23 to 25 of April 2022. Modern psychology offers a large range of scientific fields where it can be applied. The goal of understanding individuals and groups (mental functions and behavioral standpoints), from this academic and practical scientific discipline, aims ultimately to benefit society. The International Conference seeks to provide some answers and explore the several areas within the Psychology field, new developments in studies and proposals for future scientific projects. The goal is to offer a worldwide connection between psychologists, researchers and lecturers, from a wide range of academic fields, interested in exploring and giving their contribution in psychological issues. We take pride in having been able to connect and bring together academics, scholars, practitioners and others interested in a field that is fertile in new perspectives, ideas and knowledge. We counted on an extensive variety of contributors and presenters, which can supplement the view of the human essence and behavior, showing the impact of their different personal, academic and cultural experiences. This is, certainly, one of the reasons there are several nationalities and cultures represented, inspiring multi-disciplinary collaborative links, fomenting intellectual encounters and development. InPACT 2022 received 364 submissions, from more than 35 different countries all over the world, reviewed by a double-blind process. Submissions were prepared to take the form of Oral Presentations, Posters and Virtual Presentations. 121 submissions (overall, 33% acceptance rate) were accepted for presentation at the conference. The Conference addresses different categories inside Applied Psychology area and papers fit broadly into one of the named themes and sub-themes. This book contains the results of the different researches conducted by authors who focused on what they are passionate about: to study and develop research in areas related to Psychology and its applications. It includes an extensive variety of contributors and presenters that are hereby sharing with us their different personal, academic and cultural experiences. [This document contains the proceedings of the International Psychological Applications Conference and Trends (InPACT) 2022, held in Funchal, Madeira Island, Portugal, from April 23-25, 2022. The proceedings were published by inScience Press. For the 2021 proceedings, see ED622091.]
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AimsOur aim was to improve the quality and consistency of care given to young people who presented to our urban Emergency Department (ED) with self-harm.MethodsWe evaluated Hospital Episode Statistics to assess the number of young people presenting to our ED with self-harm over a 6 month period from 2020-2021. We distributed a questionnaire to all staff members working with young people in ED, in order to understand our current practice of support measures offered. This received 26 responses. Following this, we introduced an information pack collating relevant resources and created a website to signpost young people and their families to appropriate local and national support. We liaised closely with CAMHS and Paediatric staff to raise awareness of the information pack and ensure consistent implementation.ResultsHospital statistics showed that the number of young people presenting with self-harm increased by 30% in late 2020 and early 2021, following the initial COVID-19 lockdown. Our initial staff questionnaire highlighted that there was significant variation in practice, and that ED doctors wanted information and resources to give to young people and their carers. People were signposting to 20 different resources although 4 respondents denied signposting. We produced a paper information pack and collated resources on an easy-to-access website. CAMHS practitioners working with young people who self-harm valued the information packs and fed back that families appreciated having a guide of helpful resources to take away. This work led to the development of a guideline to provide a clear pathway of care of young people who self-harm for all health professionals to follow.ConclusionSelf harm commonly presents to the Emergency Department and cases have increased locally and nationally during the pandemic. A readily available information pack and website providing easy access to local and national resources can improve the quality and consistency of care given to young people presenting with self-harm. This project highlighted the importance of integrated care, bringing paediatric and CAMHS colleagues together to improve the care and support for young people and their families at a very vulnerable and stressful time.
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The unprecedented use of lockdown and quarantine to combat the spread of coronavirus disease 2019 (COVID-19) severely disrupted young people's social worlds. Both short- and long-term negative consequences were widely predicted for adolescent mental health, which was, however, reported to be deteriorating before the COVID-19 pandemic. By taking a microperspective, exploring in depth the experiences of therapeutic work with young people with suicidal thoughts or behavior, including two composite case examples, this article provides a nuanced understanding of the pandemic's effects. The discussion links the accounts of these cases, firstly, with evidence to date about the patterns that are emerging regarding the effects of the pandemic and, secondly, with theories of the relationship between suicidal thoughts and behavior and the impasse/breakdown in the adolescent developmental processes. In conclusion, it is suggested that the capacity to negotiate loss and change are crucial for sustaining development despite the COVID-19 pandemic and often in the face of overwhelming anxieties. [Psychiatr Ann. 2022;52(8):318–322.]
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AimsDue to the demand for increased flexibility of working there is an ever-increasing number of trainees working Less Than Full Time (LTFT). The Royal College of Psychiatrists supports LTFT training and careers within the specialty. However, applying for and working LTFT can be a challenging and at times overwhelming process to navigate. This project's aims are to improve written information provided to trainees when commencing LTFT training. To assess interest for a LTFT training educational event and to plan this event based on trainees preferences for content and timing.MethodsQuestionnaires via SurveyMonkey were sent to higher trainees in all regions of the Yorkshire and Humber Deanery in October 2021 by the Medical Education Departments. A covering email invited those working or interested in LTFT to complete the questionnaire.Questions assessed the need for further written information on LTFT training in the region and interest in an educational event. Trainees already working LTFT were asked what they valued most out of support already in place.ResultsOf 40 trainees who responded, 100% stated when commencing LTFT training they would wish to receive more information. Respondents were asked which areas they would like included: practicalities (100% of respondents), LTFT mentor (85%), peer support (83%), weblinks to information (70%), recommended reading (53%). Those already working LTFT were asked what they had found helpful, the most common themes were mentoring, peer and supervisor support.85% of trainees surveyed confirmed they would be interested in attending a LTFT focused educational event. Based on trainee preferences the areas to be included were job planning (78%), choosing a job (81%), clinical lead views (78%), finances (86%), Out Of Programme opportunities (61%) and emotional aspects (61%). Further questions clarified preferences for a virtual Vs face-to-face meeting and timing to maximise attendance.ConclusionThere is a need for further information to be provided to trainees on LTFT training in the region. The content has been guided by trainees and will be incorporated into the Higher Trainee Handbook.For those training LTFT the most helpful aspect has been mentoring, peer and supervisor support. We have subsequently linked with the established mentoring scheme and those new to LTFT are matched with an established LTFT trainee. We recommend 3 monthly LTFT peer and Training Programme Director meetings continue.There is considerable interest in an educational event focused on LTFT working. This has been organised for May 2022 and the content guided by trainee's preferences.
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AimsTo explore the differences in admissions between the first COVID-19 lockdown cohort and a pre-COVID-19 cohort.Methods23 young people who were admitted to an East Midlands General Adolescent Inpatient Unit during the first COVID-19 lockdown from March 2020 to September 2020 were compared with the 48 young people who were admitted in the same period in 2019. Demographic details, admission duration and reasons, mental health act (MHA) status, diagnoses, functional status, and incidents were obtained retrospectively from the trust's online records.ResultsThe unit received more female admissions prior to lockdown (60.4% Vs 47.8%). Approximately 30% of adolescents in the pre-COVID-19 group were not in education whereas those admitted during COVID-19 were all receiving education. More of the pre-COVID-19 group attended school than college and more of the COVID-19 group were employed, consistent with a lower mean age of admission in the former group. Most of the COVID-19 admissions were local and none were out of area. Young people were also more likely to be looked after by their parents during COVID-19 (82.6%) and none were taken care of by their relatives.Pre-COVID019 admissions were discharged sooner than their counterparts, which had 13% of admissions between 6–9 months. Both cohorts had mainly informal admissions due to risk to self. Most of the COVID-19 admissions were due to anxiety, followed by self-harm while the majority of pre-COVID-19 admissions were due to depression and PTSD. 43% of the COVID-19 admissions had at least one comorbid diagnosis, notably depression. More adolescents in the COVID-19 cohort were not started on any psychiatric medication during and after admission.The mean number of incidents were two times higher in the COVID-19 group;self-harm was the most common reason. There was more violence towards staff during lockdown. However, absconsion, possession of contraband items, and staff error were higher in the pre-COVID-19 group.ConclusionThe introduction of COVID-19 restrictions was associated with a change in both the frequency and nature of inpatient admissions to this ward. Less young people were admitted during COVID-19, more frequently with anxiety as the primary reason and stayed for longer. Although the pre-COVID-19 group received more psychiatric medication, it is unclear if this contributed to a better functional status overall. This service evaluation also demonstrated the impact of COVID-19 on young people's mental health and life circumstances. An exploration of these trends in other units across the country would increase the generalisability of results.
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BackgroundSuicide is one of the leading causes of death. The current systematic review is done to know the trend of suicidal thoughts, suicidal ideation, and self-harm during COVID-19 pandemic.Main textThe search was done by using PubMed, ScienceDirect, and Google Scholar databases. With the help of Mendeley portal, articles were retrieved on the basis of inclusion criteria like to know the risk factors, vulnerable group, complete article PDFs, prevention strategies, aims, results, and limitations. The shortlisted data from search was tabulated, and the PRISMA chart was framed based on the inclusion and exclusion criteria.ResultSixteen studies that satisfied the inclusion criteria were organized and selected. The variables and global scenario were considered in databases. It has been noticed that trends of suicidal thoughts, suicidal ideation, and self-harm remains the same in some countries like Japan, whereas in some countries like Bangladesh and France, trends of suicides had increased during the pandemic period. The probable cause could be lockdown, social isolation, and stoppage of recreational activities.ConclusionsThe trends of suicidal ideation, suicidal thoughts, and self-harm are more in vulnerable categories like health care professionals, university students, elderly individuals, and psychiatrically ill patients. In health care professional, it is due to the increased risk of contagion and watching deaths closely. In university students, it is due to the lack of recreational activities and social isolation. Among elderly, it is due to thinking themselves as overburden. The increase in suicidality in psychiatric ill patient admitted during COVID-19 pandemic is due to unknown cause.
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IntroductionThe WHO declared a global pandemic on 11 March 2020. Since then, the world has been firmly in the grip of the COVID-19. To date, more than 211 730 035 million confirmed cases and more than 4 430 697 million people have died. While controlling the virus and implementing vaccines are the main priorities, the population mental health impacts of the pandemic are expected to be longer term and are less obvious than the physical health ones. Lockdown restrictions, physical distancing, social isolation, as well as the loss of a loved one, working in a frontline capacity and loss of economic security may have negative effects on and increase the mental health challenges in populations around the world. There is a major demand for long-term research examining the mental health experiences and needs of people in order to design adequate policies and interventions for sustained action to respond to individual and population mental health needs both during and after the pandemic.Methods and analysisThis repeated cross-sectional mixed-method study conducts regular self-administered representative surveys, and targeted focus groups and semi-structured interviews with adults in the UK, as well as validation of gathered evidence through citizens’ juries for contextualisation (for the UK as a whole and for its four devolved nations) to ensure that emerging mental health problems are identified early on and are properly understood, and that appropriate policies and interventions are developed and implemented across the UK and within devolved contexts. STATA and NVIVO will be used to carry out quantitative and qualitative analysis, respectively.Ethics and disseminationEthics approval for this study has been granted by the Cambridge Psychology Research Ethics Committee of the University of Cambridge, UK (PRE 2020.050) and by the Health and Life Sciences Research Ethics Committee of De Montfort University, UK (REF 422991). While unlikely, participants completing the self-administered surveys or participating in the virtual focus groups, semi-structured interviews and citizens’ juries might experience distress triggered by questions or conversations. However, appropriate mitigating measures have been adopted and signposting to services and helplines will be available at all times. Furthermore, a dedicated member of staff will also be at hand to debrief following participation in the research and personalised thank-you notes will be sent to everyone taking part in the qualitative research.Study findings will be disseminated in scientific journals, at research conferences, local research symposia and seminars. Evidence-based open access briefings, articles and reports will be available on our study website for everyone to access. Rapid policy briefings targeting issues emerging from the data will also be disseminated to inform policy and practice. These briefings will position the findings within UK public policy and devolved nations policy and socioeconomic contexts in order to develop specific, timely policy recommendations. Additional dissemination will be done through traditional and social media. Our data will be contextualised in view of existing policies, and changes over time as-and-when policies change.
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Suicide in people between the ages of 15 and 24 is one of the top three causes of death. The aim of this research is to compare and associate performance in working memory, attention, and inhibitory control with the presence of suicidal behavior in adolescents. Research design was cross-sectional and the convenience sample consisted of 65 adolescents from the city of Temuco, Chile. The instruments used for data collection were: 1) the Okasha Suicidality Scale, 2) span of direct and indirect digits, and 3) the Stroop test. The results show that 49.3% of the adolescents had suicidal ideation. In terms of the groups, an association and significant differences were found in the Stroop test;this occurred specifically in the female sex (p < .05). In the rest of the tasks that measured memory and attention, no differences were observed (p > .05). It is concluded that suicidal behavior is associated with a lower performance in inhibitory control tasks for females.Alternate : El suicidio en personas entre 15 y 24 años es una de las tres primeras causas de muerte. El objetivo de este trabajo ha sido determinar la asociación de la memoria de trabajo, la atención y el control inhibitorio con la presencia de conducta suicida en adolescentes. Se ha utilizado un diseño de investigación transversal y una muestra por conveniencia compuesta por 65 adolescentes de la ciudad de Temuco, Chile. En la recolección de datos se utilizaron :1) la Escala de Suicidalidad Okasha, 2) la amplitud de dígitos directos e indirectos y 3) el test de Stroop. En el 49.3% de los adolescentes se presentó ideación suicida, encontrando diferencias significativas en el test de Stroop, esto ocurre específicamente en el sexo femenino (p < .05). Se concluye que la conducta suicida está asociada a un desempeño más bajo en tareas de control inhibitorio para el sexo femenino.
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The Pan American Health Organization and Amnesty International have called on governments to do more to protect health care workers, for example, by distributing simple, accessible information to combat the spread of misinformation. The authors found that the injury rate was higher in rural and remote areas than in urban areas and that a decline in firearm-related injuries occurred over the study period. Out-of-hospital disputes were also an important cause of serious hospital violence (11%). [...]interviewed health care workers expressed an urgent need for legislation, increased security, and training to handle disputes to prevent the violent incidents against health care workers and protect their safety.
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PurposeIn response to elevated local self-harm and suicide rates, and the lack of a dedicated pathway for children and young people (CYP) who self-harm, a rapid response pathway united to reduce self-harm (RUSH) was developed and implemented within Norwich (Norfolk, England). This public health case study aims to describe the pathway model and share its outcomes, learnings, and reflections over the pilot year.Design/methodology/approachRUSH was a community-based pilot pathway aiming to support CYP, 11–18 years old, engaging in or at risk of engaging in repeated self-harm and subsequently at risk of repeated attendance at local emergency departments. From May 2020 to April 2021, RUSH supported 61 CYP using funding from NHS England and Improvement.FindingsThis case study shares the pathway’s outcomes, through a mixed-method evaluation. Results indicate statistically significant reductions in self-harm frequency (p = 0.01) and anxiety and depression symptomatology (p < 0.001);a statistically significant increase in progress towards goals (p < 0.001);and a general downward trend in re-attendance at local emergency departments following RUSH. Findings also illustrate high service user satisfaction. Framework analysis of focus group data highlights positive experiences with hope for recommissioning from a staff perspective.Originality/valueThis study will be valuable for services looking to develop and implement a similar service provision, in response to the need to tackle self-harm rates as a broader approach to suicide prevention. In light of the NHS long-term plan (2019), it also serves as an example of how to develop and use a strategic co-production group, and work collaboratively with the voluntary, community and social enterprise sectors.
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The contributors are particularly attentive to the social and structural dimensions of suicide and self-harm. Since Emile Durkheim’s Le suicide (1897), we know that suicide transcends the individual and reflects broad structural divisions and inequalities in society at a given historical period. In the UK, for instance, there was an increase of 96% in the in the number of children and young people referred to mental health services between April and June 2021 compared with the same period in 2019 (RCP, 2021). According to one study, the highest rise in prevalence of self-harm over the past ten years is among young women aged 16–24 years (Mayor, 2019).
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Combining data from 12 UK population studies, they found that people with poor pre-pandemic mental health experienced greater overall disruption to their lives across multiple domains, but specifically greater likelihood of economic and healthcare disruptions. Prior research demonstrating that clinician questions about suicidal behaviour don't increase the risk of such behaviour has been reassuring and influential for conducting safe and good-quality risk assessments. Using data from The Netherlands and Belgium, where psychiatric euthanasia and/or medically assisted suicide (EAS) is permitted, they critically examine the difference between EAS and suicide – arguing that the characterisation of suicide as impulsive or violent is not necessarily an accurate or sufficient distinction from the apparently calm ‘death wish’ of EAS.
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The aim of this study was to identify the epidemiological profiles of violence against children, victims, and their aggressors, and their correlations between socioeconomic and demographic factors analyzed before and during the COVID-19 pandemic. This was a cross-sectional, retrospective observational study based on a review of Individual Notification Forms from the Information System for Notifiable Diseases, including child victims of violence, under 18 years, assisted by a pediatric emergency service in Brazil, from 2016-2020. Data were stratified, then statistical analysis was performed using the two-proportion equality test and the Chi-square test, with p < 0.05 and a 95% confidence interval. A total of 609 notifications were analyzed and a prevalence of sexual violence (63.2%) was reported. The prevalent profile of victim was female (76.7%), aged between 2-9 years (38.1%) and 14-18 years (35.6%). The violence occurs in the victim's home (58.9%). The prevalent profile of perpetrator was male (82.4%), young adolescent (59.2%), living as family (64%), mainly the parents (18.4%). No correlation was found between the classified socioeconomic and demographic variables and violence. There was an increase in notifications during the COVID-19 pandemic, compared to the same period in the previous year; self-harm was reported in 59.7% of physical violence in 2020. Prevalence of sexual violence was higher for females, aged between 2-9 and 14-18 years, victimized in their homes, by male offenders, living as family, mainly by their parents. No association was found between child violence and the socioeconomic and demographic.